Chapter 6: Life with arthritis in Canada: a personal and public health challenge – Economic burden of arthritis

Chapter Six: Economic burden of arthritis

Table of Contents

Introduction

Arthritis affects a substantial proportion (16%) of the Canadian population and is a leading cause of illness and disability (Chapter 1 and 3). People living with arthritis suffer pain, impaired physical function and a reduced quality of life, particularly with respect to their social, psychological and financial well-being.

This chapter presents the most recent (2000) costs attributed specifically to arthritis from the Economic Burden of Illness in Canada (EBIC) project of the Public Health Agency of Canada.

The total costs associated with arthritis reported in this chapter include both direct and indirect costs. Direct costs include hospital care expenditures (public and private), drug expenditures (publicly and privately prescribed and non-prescribed products), physician carwe expenditures (all fee-for-service and alternative payment plans), and additional health care expenditures. Indirect costs refer to the dollar value of lost production due to illness, injury or premature death and consist of the lost production attributable to short and long-term disability (morbidity costs) and the lost production associated with premature death (mortality costs).

Short-term disability costs could not be calculated specifically for arthritis. As a result, the indirect and total costs attributed to arthritis are underestimated. Costs are reported in 2000 dollars and in 2008 dollars (Table 6-1). Costs figures were converted to 2008 dollars using the Bank of Canada inflation calculator.Footnote 1

Costs Attributed to Arthritis

In 2000, the total cost of musculoskeletalFootnote * diseases (which includes arthritis) was $22.3 billion and the most costly group of diseases. The economic burden of arthritisFootnote ** in Canada was estimated to be $6.4 billion (Table 6-1), representing almost one third of the total cost of musculoskeletal diseases.

Indirect costs associated with arthritis accounted for twice the direct costs ($4.3 billion and $2.1 billion, re- spectively). With respect to direct costs, arthritis accounted for over one half of hospital care expenditures for all musculoskeletal diseases, nearly three fifths of drug expenditures, and approximately one half of physician care expenditures. For indirect costs, arthritis accounted for more than 80% of all musculoskeletal mortality costs and over one quarter of morbidity costs due to long-term disability.

Table 6-1: Economic burden of arthritis, by cost components, Canada 2000 (2008) dollars
Type of cost Component Arthritis costs
($ million)
Proportion of
musculoskeletal disease
expenditures (%)
Source: Public Health Agency of Canada, Economic Burden of Illness in Canada 2000 custom tabulations.
Short term disability costs not available for arthritis but included in musculoskeletal disease.
Direct costs
Hospital care $987.3 ($1,185.8) 54.0%
Drug $524.6 ($630.1) 57.8%
Physician care $589.4 ($707.9) 49.0%
Total direct $2,101.3 ($2,523.8) 53.4%
Indirect costs
Mortality $177.9 ($213.6) 81.4%
Long term disability $4,136.8 ($4,968.5) 26.4%
Short term disability n/a n/a
Total indirect $4,314.7 ($5,182.1) 23.5%
Total costs $6,415.9 ($7,705.9) 28.9%

Footnote *

ICD-9 710-739, 274.

Return to - Footnote * referrer

Footnote **

ICD-9 99.3, 274, 696.0, 446, 710.0-710.4, 710.9, 711-720, 725-729.

Return to - Footnote ** referrer

Text Equivalent - Table 6-1

Table 6-1

The economic burden of arthritis, by cost components, in 2000 (and 2008) dollars is presented in Table 6-1. Short term disability costs were not available for arthritis but were included in musculoskeletal disease.

In 2000, the total cost of musculoskeletal diseases which includes arthritis (ICD-9 710-739, 274) was $22.3 billion and the most costly group of diseases.  The economic burden of arthritis (ICD-9 99.3, 274, 696.0, 446, 710.0-710.4, 710.9, 711-720, 725-729) in Canada was estimated to be $6.4 billion, representing almost one third of the total cost of musculoskeletal diseases. 

Indirect costs associated with arthritis accounted for twice the direct costs ($4.3 billion and $2.1 billion, respectively). With respect to direct costs, arthritis accounted for over one half of hospital care expenditures for all musculoskeletal diseases, nearly three fifths of drug expenditures, and approximately one half of physician care expenditures.  For indirect costs, arthritis accounted for more than 80% of all musculoskeletal mortality costs and over one quarter of morbidity costs due to long-term disability.

Morbidity costs ($4.1 billion) due to long-term disability accounted for nearly two thirds of total arthritis costs in 2000, by far the largest cost component of the arthritis burden.  The largest direct cost components were hospital care expenditures ($987 million) and physician care expenditures ($589 million).



Morbidity costs ($4.1 billion) due to long-term disability accounted for nearly two thirds of total arthritis costs in 2000, by far the largest cost component of the arthritis burden. The largest direct cost components were hospital care expenditures ($987 million) and physician care expenditures ($589 million).

Total costs attributed to arthritis were greater in women than men ($4.1 billion and $2.3 billion, respectively). This reflects the greater prevalence of arthritis among women than men. Nearly two thirds (65%) of the total arthritis costs were incurred by individuals aged 35–64 years ($4.1 billion), followed by individuals aged 65 years and over ($1.7 billion) and those aged 15–34 years ($493.8 million). This emphasizes the important economic burden of arthritis in Canadian individuals of work-force age as well as seniors. Costs incurred by the youngest age group (0–14 years) were $49.3 million.

In the future, people aged 55 years of age and older will account for the greatest increase in the number of people affected with arthritis (see Chapter 1) and a high proportion of these people may face reduced participation in the labour force (see Chapter 3), so morbidity costs due to arthritis are expected to increase substantially in the future. This can be mitigated by focusing on prevention, improving health and reducing disability in order to minimize short and long disability costs and help people with arthritis to participate actively in society, including staying in the labour force.

Summary

  • In 2000, the total cost associated with arthritis was $6.4 billion which represents almost one third of the total costs attributed to musculoskeletal diseases, the most costly group of diseases in Canada.
  • The greatest economic burden associated with arthritis is attributed to long-term disability.
  • Indirect costs associated with long-term disability accounted for twice the direct costs of arthritis.
  • Total arthritis costs were greater in women ($4.1 billion) than men ($2.3 billion) because of the higher prevalence of arthritis among women.
  • Total costs incurred by individuals within the labour force (35-64 years) were over two times higher than those incurred by the elderly (65 years and over) ($4.1 billion and $1.7 billion, respectively).

Footnote *

Bank of Canada, Bank of Canada Inflation Calculator.

Return to - Footnote 1 referrer

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